Singer P A, Martin D K, Giacomini M, Purdy L
University of Toronto Joint Centre for Bioethics, Toronto, ON, Canada M5G 1L4.
BMJ. 2000 Nov 25;321(7272):1316-8. doi: 10.1136/bmj.321.7272.1316.
To describe priority setting for new technologies in medicine.
Qualitative study using case studies and grounded theory.
Two committees advising on priorities for new technologies in cancer and cardiac care in Ontario, Canada.
The two committees and their 26 members.
Accounts of priority setting decision making gathered by reviewing documents, interviewing members, and observing meetings.
Six interrelated domains were identified for priority setting for new technologies in medicine: the institutions in which the decision are made, the people who make the decisions, the factors they consider, the reasons for the decisions, the process of decision making, and the appeals mechanism for challenging the decisions.
These domains constitute a model of priority setting for new technologies in medicine. The next step will be to harmonise this description of how priority setting decisions are made with ethical accounts of how they should be made.
描述医学新技术的优先级设定。
采用案例研究和扎根理论的定性研究。
加拿大安大略省两个就癌症和心脏护理新技术优先级提供建议的委员会。
这两个委员会及其26名成员。
通过审查文件、采访成员和观察会议收集的优先级设定决策记录。
确定了医学新技术优先级设定的六个相互关联的领域：做出决策的机构、做出决策的人员、他们考虑的因素、决策的理由、决策过程以及对决策提出质疑的上诉机制。
这些领域构成了医学新技术优先级设定的模型。下一步将是使这种关于优先级设定决策如何做出的描述与关于它们应该如何做出的伦理描述相协调。
